Eight out of 10 nurses overwork in three shifts per day but only 20 percent of them request overtime pay, a survey showed.

The health and medical workers’ union under the Korean Confederation of Trade Union on Monday unveiled its fact-finding survey on nurses’ extra labor in three shifts.

The medical workers’ union surveyed from June to October on nurses working in three shifts at Kangwon National University Hospital, Kyungpook National University Hospital, Dongguk University Hospital in Gyeongju, Dong-A University Hospital, Seoul National University Hospital, Ulsan University Hospital, and Chungbuk National University Hospital. Among them, all of the nurses at Ulsan and Kyungpook Hospital participated in the survey.

Out of the 2,332 respondents, 79.6 percent, or 1,856, said they overworked. However, only 20.5 percent, or 381, said they requested extra pay. The respondents’ combined overwork stood at 8,520 hours for four months, meaning they overworked for 4.6 hours a week on average. However, their combined hours for extra pay only reached 1,364 hours or 16 percent.

The health and medical workers’ union said the annual overdue wages of overworked nurses at the seven hospitals amounted to more than 16.06 billion won ($14.7 million), based on calculations of the average wage all members of the union received in 2016 or 2017.

Reasons for extra work included “emergency patients needing care in times of shifts” (57.6 percent) and “too many patients and too much work” (55.1 percent), in multiple responses. Others said, “to help colleague nurses” (16.5 percent) and “not familiar with tasks” (13.2 percent).

Nurses said they could not request extra pay after overwork because “the whole atmosphere is hostile to such request,” with 49.3 percent of the respondents saying so. About 5.7 percent of them said their request was not approved, while 21.8 percent said their hospitals did not have any system for extra pay request.

To prevent extra work, the respondents said hospitals should increase hiring of nurses to reduce the number of patients per nurse.

To a question, “what kind of solutions would you offer to get rid of overwork,” 87.9 percent responded with “a reduction in the number of patients per nurse by employing more nurses.” Another 21.5 percent said nurses could reduce their work by handing over the work of physicians to the physicians.

Nurses working in three shifts also had to sacrifice their time for early work, training, and meetings. About 71 percent, or 1,652 nurses, said they had to get to work early. Per person, they went to work 3.9 hours earlier than schedule a week.

A majority of 65.2 percent, or 1,521, said their extra time is also spent on training and meetings. They spent 2.5 hours on average for training and meetings a month. Although it was overwork, only 4.5 percent applied for extra pay. The reason they get to work early was they could not complete their work due to excessive workload, with 60 percent of them saying so.

“The survey results show that chronic nurse shortages stay unresolved at hospitals,” said the medical workers’ union under the KCTU. “The atmosphere pressuring nurses not to request extra pay allows hospitals to maintain status quo with no-paid work. Thus, hospitals do not hire more nurses.”

The union went on to say, “Hospitals should immediately pay overdue wages. By doing so, we should change the hospital culture, which is now hostile to extra pay requests, and coerce hospitals to employ more nurses.”

The union also urged the Ministry of Employment and Labor to monitor labor practices strictly and take corrective measures. “As hiring of more nurses is a significant issue, other related agencies, including the Ministry of Health and Welfare, should force hospitals to carry out recruits,” it added.